6 year-old girl with a somewhat reduced general constitution, sporadic fever. Some swelling and obvious pain in the left parotid gland. The child was of german descent, no time spent in foreign countries. One year ago, short drainage in an opening of a fistula pre-auricular (left). Then, spontaneous healing without further investigation. Presently, anewed problems with the healed fistula and drainage of a purulent secretion.

Pathomorphology or Pathophysiology of this disease :

N/A

Radiological findings:

MRI 1: T1 FatSat after contrast, coronal : Left-sided contrast uptake. Fistula through the parotid gland with enhancement along the edges and subcutaneous widening to a small, cavernous absces which has perforated the skin.

MRI 2: T1 FatSat after contrast, transversal: Left-sided contrast uptake. Fistula through the parotid gland with enhancement along the edges and subcutaneous widening to a small, cavernous absces which has perforated the skin. In general, small findings with homogenic signal intensity and enhancement along the edges.

MRI 3: T2-with fat-saturation, coronal: hyperintense mass with contact to the outer auditory duct with relatively low surrounding reaction in the left parotid gland. No extraparotid edema. In general, small findings with homogenic signal intensity and enhancement along the edges.

MRI 4: T2- with fat-saturation, transversal: hyperintense mass with contact to the outer auditory duct with relatively low surrounding reaction in the left parotid gland. No extraparotid edema. In general, small findings with homogenic signal intensity and enhancement along the edges.

Diagnosis confirmation:

Surgery / Histo

Which DD would be also possible with the radiological findings:

Abscess of the parotid gland resulting from sialolithiasis.TuberculomaResult of a parasitic illnessLymphoma

(everything even rarer and therefore unlikely)

Course / Prognosis / Frequency / Other :

Intraoperatively difficult resection of the teratoma from the external ear canal.After surgery, healing was without complication.Prognosis: very good, reoccurrance very seldom.Intraoperatively, there was hair and epithelia found in the teratoma. No teeth or ossifications.